Short-term prospective effects of impulsivity on binge drinking: mediation by positive and negative drinking consequences

Development and Validation of the Positive Outcomes of Cannabis Use Scale (POCUS) Among Predominantly White Adults in the United States

Operant conditioning and social learning theories suggest that positive cannabis use-related outcomes are a primary contributor to maintained use and risk for dependence. However, currently there does not exist a reliable, validated measure of positive cannabis-related outcomes. This study sought to develop and psychometrically evaluate the Positive Outcomes of Cannabis Use Scale (POCUS). We collected three samples, college students (N = 883), community adults (N = 214), and college students (N = 615), of predominantly White adults in the United States who completed an online survey. Exploratory and confirmatory factor analyses evaluated scale structure and identified four factors: social enhancement, mood enhancement, cognitive enhancement, and sexual enhancement. Positive outcomes were positively associated with recent use, controlling for expectancies and negative outcomes. Positive outcomes were also differentiated from positive expectancies and more influential in predicting typical use frequency. Findings indicate that the POCUS is psychometrically sound and clinically useful for measuring positive cannabis use-related outcomes among predominantly White adults in the United States.

Pathways of personality and learning risk for addictive behaviors: A systematic review of mediational research on the Acquired Preparedness model

OBJECTIVE

The Acquired Preparedness (AP) model proposes that impulsive personality traits predispose some individuals to learn certain behavior-outcome associations (expectancies), and that these expectancies in turn influence the escalation of risky behaviors. This theory has been applied to the development of behaviors such as drinking, drug use, gambling, and disordered eating. In the current study, we aimed to summarize empirical tests of this model over the 20 years since it was proposed.

METHOD

We used a descriptive approach to summarize tests of mediation across 50 studies involving n=21,715 total participants.

RESULTS

We observed a consistent effect of personality on expectancies (median effect size = .22), of expectancies on behavior (.24), and a small mediated effect (.05) of personality on behavior via expectancies. Impulsive traits that involve positive or negative affect showed the most consistent support for AP, as did positive expectancies. Most studies testing AP focused on alcohol, but research on other behaviors also showed support for AP.

CONCLUSIONS

The literature appears to support a small mediated effect consistent with the AP model. Future research should continue to clarify which AP pathways are most influential in explaining risky behaviors, and supplement correlational research with experimental and quasi-experimental designs.

Prescription Stimulant Misuse and Risk Correlates among Racially-Diverse Urban Adolescents

BACKGROUND

Most research on prescription stimulant misuse has focused on college students, and research on high school-aged adolescents is limited.

OBJECTIVES

This study aimed to characterize risk correlates of prescription stimulant misuse among a racially-diverse and socioeconomically-disadvantaged sample of urban adolescents.

METHOD

Cross-sectional data were drawn from an ongoing study of adolescent health behaviors, Project Teen. Participants were 414 9^th to 11^th graders (M_age=16.00 [SD = 1.08]; 57% female; 41% Black or African American, 22% White, 18% Asian, 17% Multiracial, 2% Pacific Islander, and 1% Native American; 12% Hispanic/Latinx). Participants completed a web-based survey assessing prescription stimulant misuse, demographics, mental health and personality, social environment, and substance use.

RESULTS

Eight percent of participants endorsed past-year prescription stimulant misuse. Compared to non-misusing peers, participants endorsing past-year prescription stimulant misuse reported greater depression/anxiety symptoms, sensation seeking, perceived peer risk behavior, and alcohol and cigarette use, as well as a lower level of parental monitoring; null group differences were observed for academic goal orientation, perceived peer approval of risk behavior, and cannabis use. Binary logistic regression demonstrated that binge drinking and cigarette use were significantly associated with prescription stimulant misuse over and above all other identified risk variables.

CONCLUSIONS

Adolescent prescription stimulant misuse appears to overlap with general adolescent substance use, sharing several known risk correlates. Results highlight potential targets for identification of emerging prescription stimulant misuse risk profiles at earlier stages of development. Longitudinal replication is needed to examine directional associations and risk mechanisms underlying adolescent prescription stimulant misuse.

Sleep-related functional impairment as a moderator of risky drinking and subsequent negative drinking consequences in college students

OBJECTIVE

Poor sleep quality and insufficient total sleep time have been shown to modify the relationship between college drinking and negative drinking consequences. This study aimed to examine whether prospective associations between risky drinking and negative drinking consequences similarly differ by sleep-related functional impairment, which is novel to the literature.

METHOD

Data were obtained from a 2-month prospective study of 157 college drinkers (mean age = 19 years [SD = 1.11], 30% male, 76% White). Online questionnaires were administered at both Time 1 (T1) and Time 2 (T2) to measure sleep-related functional impairment (assessed by Insomnia Diurnal Impact Scale; Ruiz, Guilera, & Gomez-Benito, 2011) and drinking behaviors and negative drinking consequences (assessed retrospectively over the past 2 months).

RESULTS

Prospective negative binomial regression analyses demonstrated that associations of both maximum drinks and binge drinking frequency at T1 with negative drinking consequences at T2 differed by T1 sleep-related functional impairment after controlling for covariates (sex, negative mood, total sleep time, insomnia symptoms, morning preference, and negative drinking consequences at T1). Students reporting lower sleep-related functional impairment experienced high levels of negative drinking consequences only at high levels of risky drinking, whereas students reporting higher sleep-related functional impairment experienced consistently high levels of negative drinking consequences regardless of their risky drinking levels.

CONCLUSION

Findings indicate that sleep-related functional impairment may exacerbate negative drinking consequences of risky drinking. Thus, sleep-related functional impairment helps to explain individual differences in the association between risky drinking and negative drinking consequences in college students.

A Causal Model of Binge Drinking Among University Students in Northern Thailand

Binge drinking, an extreme drinking pattern and the most common form of hazardous alcohol consumption among university students, has remained a public health concern with physical, psychological, academic, and social problems. Tracking multiple factors is needed to find ways to deal with such hazardous drinking patterns and their adverse consequences. In Thailand, the particular factors leading to binge drinking patterns among university students are still not recognized. Four hundred thirteen university students in Northern Thailand self-administered a Web-based survey about the causal factors. The survey was based on a hypothesized model from the Social Ecological Model and from empirical studies. There were four factors that were hypothesized to directly increase binge drinking behavior: attitudes toward drinking, peer influence, physical environments of drinking, and alcohol advertisements. However, there were another four factors that were hypothesized to directly decrease binge drinking behavior: drinking refusal self-efficacy, university alcohol regulations, alcohol public policies, and knowledge. Through testing of the hypothesized model by Structural Equation Modeling, the causal model of binge drinking among Thai university students revealed "binge drinking refusal self-efficacy" (β = -.22, p < .001) and "peer influence" (β = -.14, p < .05) as significant negative factors and "physical environments" (β = .18, p < .001) as a positive predictor regarding binge drinking. The study shows how healthcare providers may be able to lessen binge drinking by designing effective prevention programs centering on an intrapersonal factor (binge drinking refusal self-efficacy), an interpersonal factor (peer influence), and a community factor (physical environments).

Self-Medication for Sleep in College Students: Concurrent and Prospective Associations With Sleep and Alcohol Behavior

OBJECTIVE/BACKGROUND

College students are at an increased risk for poor sleep and associated sleep problems. Emerging evidence suggests that a substantial subset of college students self-medicate with alcohol, marijuana, or over-the-counter medications to help sleep. The current study identified demographic, psychosocial, and sleep- and alcohol-related correlates of self-medication for sleep, and assessed its concurrent and prospective associations with insomnia symptoms, alcohol drinking, and negative drinking consequences.

PARTICIPANTS

Undergraduate students (N = 171; mean age = 19 years [SD = 1.35], 32% male, 74% White) enrolled in a four-year university in the northeastern United States.

METHODS

Data were drawn from a short-term two-wave longitudinal study. Participants completed two online surveys, separated by an average interval of 68 days (SD = 10.22).

RESULTS

At Time 1, 25% of students reported using at least one substance (alcohol, marijuana, or over-the-counter medications) for sleep aid in the past two weeks. Male and older students were more likely to report using substances for sleep. Sleep aid use at Time 1 was concurrently associated with greater levels of alcohol frequency, negative drinking consequences, and insomnia symptoms. Further, sleep aid use at Time 1 was associated with an increase in negative drinking consequences from Time 1 to Time 2, but not with changes in alcohol frequency or insomnia symptoms.

CONCLUSIONS

These findings indicate that substances are widely used among college students for sleep aid. Sleep aid use is associated with greater concurrent drinking and insomnia symptoms, and increases in negative drinking consequences over a short time period.

Bidirectional Relations of Impulsive Personality and Alcohol Use Across Three Waves of Data Collection

OBJECTIVE

To explore the bidirectional relations between alcohol use and three impulsive personality traits, to advance understanding of risk processes.

PARTICIPANTS

525 college students (mean age = 18.95 years) recruited in August 2008 and 2009 and followed up annually for three years.

METHODS

Personality and past/current substance use were assessed.

RESULTS

T2 sensation seeking mediated the predictive relationship between T1 and T3 alcohol use, and T2 alcohol use mediated the predictive relationship between T1 and T3 sensation seeking. In addition, T2 alcohol problems mediated the predictive relationship between T1 alcohol use and T3 negative urgency.

CONCLUSIONS

Findings support a bidirectional relationship between sensation seeking and alcohol use, and drinking anticipates drinking problems, which predict increases in negative urgency. For some individuals, there appears to be an ongoing process of increased risk in the form of increases in both drinking and high-risk personality traits.

The influence of context in the subjective evaluation of "negative" alcohol-related consequences

College students may subjectively evaluate the consequences of drinking in unexpected ways, rating "negative" consequences as neutral or even positive experiences. We previously gathered qualitative evidence for several contextual factors that may influence one's subjective evaluations (e.g., social influences, intoxication level, concurrent positive consequences). The purpose of the present study was to quantitatively investigate whether student evaluations of consequences differ by various contextual factors. We administered an anonymous online survey to 214 college students (76% female, 69% drinkers, 48% heavy drinkers) in return for academic credit, on which they reported how positively or negatively they would evaluate 6 alcohol-related consequences (e.g., vomiting, being rude, blacking out) under different conditions. Paired samples t tests were used to compare evaluation ratings, averaged across consequences, under different hypothetical contextual conditions (e.g., among friends vs. strangers). Out of 16 contextual comparisons, all but one (first-time vs. repeated consequence) revealed significant differences in subjective evaluations; the pattern held in reduced samples of just drinkers or just heavy drinkers. Examples include that consequences were viewed more negatively (a) if occurring at either a party or bar versus alone in one's home/dorm, (b) if friends express concern versus find it funny, (c) if the consequence was expected versus unexpected, and (d) if there are lasting consequences versus none. When using recent consequences in feedback-based interventions to build motivation to change, it may be useful to discuss the context of a consequence and how this influences the perceived aversiveness of that consequence. (PsycINFO Database Record

Binge drinking: Health impact, prevalence, correlates and interventions

OBJECTIVE

Binge drinking (also called heavy episodic drinking, risky single-occasion drinking etc.) is a major public health problem. This paper provides an overview of recently published evidence concerning the definition and measurement, prevalence rates, health impact, demographic and psychosocial correlates of, and interventions for, binge drinking.

DESIGN

Narrative review.

RESULTS

Mostly occurring among young people at weekends, binge drinking increases the risk of both acute (e.g. injuries) and long-term negative consequences (e.g. alcohol disorders). Binge drinkers tend to be extrovert, impulsive and sensation-seeking. Stress, anxiety, traumatic events and depression are also related to binge drinking. Both alcohol-related behaviour of parents and general parenting (e.g. parenting styles, monitoring) are also important. Other major risk factors for binge drinking are frequently spending time with friends who drink, and the drinking norms observed in the wider social environment (e.g. school, community, culture). Emergency departments, birthday parties, fraternities and the workplace serve as settings for interventions; these are increasingly delivered via digital and mobile technology. There is evidence of small-sized effects across approaches (brief interventions, personalised normative feedback, protective behavioural strategies etc.) and populations.

CONCLUSION

A more consistent terminology, investigating multi-level influences and identifying the most effective intervention components are challenges for future research.

The associations among prior drinking consequences, subjective evaluations, and subsequent alcohol outcomes

Although the many positive and negative psychosocial consequences of alcohol use are well documented, evidence of the association between prior drinking consequences and subsequent alcohol-related outcomes is mixed. Social learning theory highlights that cognitive appraisals of prior drinking consequences play a crucial intermediate role in the relation of prior drinking consequences with subsequent alcohol-related outcomes. This prospective study was designed to test the mediating effects of subjective evaluations (i.e., perceived valence and controllability) in the association of prior drinking consequences with change in binge drinking and drinking consequences over time. Participants were 171 college students (69% female, 74% White, M age = 18.95 years, SD = 1.35) who completed 2 online surveys, with an average interval of 68 days (SD = 10.22) between assessments. Path analyses of the data did not support mediational effects of perceived valence or controllability of prior drinking consequences on subsequent alcohol-related outcomes. Specifically, greater frequency of negative consequences was associated with lower perceived valence and controllability, and greater frequency of positive consequences was associated with lower perceived controllability of the experienced consequences. However, perceptions of valence and controllability were not in turn associated with subsequent binge drinking and drinking consequences. Instead, greater frequency of positive consequences was directly associated with greater subsequent frequency of binge drinking. Findings highlight the importance of prior positive consequences in the escalation of binge drinking over a short period of time, although this relation may not be accounted for by perceptions of valence and controllability of the prior drinking consequences. (PsycINFO Database Record